Journal of the Saudi Heart Association最新文献

{"title":"Intravenous Atropine in Reducing Reperfusion Arrhythmias, Conduction Abnormalities, and Hypotension in Inferior ST-elevation Myocardial Infarction Undergoing Primary Percutaneous Coronary Intervention.","authors":"Mohamed I Rashed, Islam M Bastawy, Ahmed L Mohamed, Mohamed G Elewa","doi":"10.37616/2212-5043.1505","DOIUrl":"10.37616/2212-5043.1505","url":null,"abstract":"<p><strong>Objectives: </strong>Inferior ST-segment elevation myocardial infarction is frequently complicated by vagally mediated bradyarrhythmias and hypotension during reperfusion, contributing to increased morbidity. The Bezold-Jarisch reflex has been implicated in this hemodynamic instability; however, evidence supporting prophylactic atropine remains limited. The study evaluated whether intravenous atropine administered immediately before reperfusion reduces clinically meaningful bradyarrhythmias, hypotension, early sustained ventricular arrhythmias, and inpatient major adverse cardiovascular events in patients undergoing primary percutaneous coronary intervention.</p><p><strong>Methods: </strong>In this prospective single-center, randomized, double-blind, placebo-controlled trial, adults presenting within 12 h of symptom onset with inferior ST-segment elevation myocardial infarction were randomized 1:1 to intravenous atropine (1 mg) or placebo immediately before guidewire crossing or balloon inflation. Of 158 patients randomized, 150 patients were included in a prespecified modified intention-to-treat analysis, excluding 8 patients with angiographic no-reflow. The primary endpoint was a composite of hypotension and symptomatic bradycardia following reperfusion. Secondary endpoints included the individual components of the primary endpoint, sustained ventricular tachycardia or ventricular fibrillation, and inpatient major adverse cardiovascular events.</p><p><strong>Results: </strong>The primary endpoint occurred in 17.3% of atropine-treated patients and 49.3% of placebo-treated patients (relative risk 0.35, 95% CI 0.20-0.61), corresponding to an absolute risk reduction of 32.0% (95% CI 17.81-46.19) and a number needed to treat of 3 (p < 0.001). Atropine significantly reduced hypotension and symptomatic bradycardia. Sustained ventricular tachycardia or ventricular fibrillation occurred in 2.7% vs 13.3% of patients. No serious atropine-related adverse events were observed.</p><p><strong>Conclusions: </strong>Prophylactic atropine significantly reduces hypotension and bradyarrhythmias and may also reduce early ventricular arrhythmias and inpatient major adverse cardiovascular events in this population.</p><p><strong>Clinical trial registration: </strong>ClinicalTrials.gov identifier NCT07268586, retrospectively registered December 2025.</p>","PeriodicalId":17319,"journal":{"name":"Journal of the Saudi Heart Association","volume":"38 2","pages":"10"},"PeriodicalIF":1.4,"publicationDate":"2026-05-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13267966/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148265210","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Patent Ductus Arteriosus Spasm During Percutaneous Device Occlusion in Infants and Children.","authors":"Hani M Adel, Ashraf K Mahmoud","doi":"10.37616/2212-5043.1502","DOIUrl":"10.37616/2212-5043.1502","url":null,"abstract":"<p><strong>Background: </strong>Spasm of ductus arteriosus is an uncommon but significant phenomenon associated with transcatheter patent ductus arteriosus (PDA) occlusion. It can lead to procedural failure, improper device sizing, or even embolization of the occluder device as the spasm subsides post-procedure. Aim of this study is to report the frequency, features, management and outcome of PDA spasm during device closure in a single Egyptian center.</p><p><strong>Patients and methods: </strong>Over about 3 years, 200 infants and children underwent percutaneous device occlusion. The echocardiographic and catheterization data of patients who developed spasm of PDA before or during or shortly after anesthesia induction or upon catheter entry into PDA were recorded and analyzed. Upon detecting the spasm, the anesthetist managed it by increasing the depth of anesthesia through a higher minimum alveolar concentration of inhaled sevoflurane and administering a secondary opioid dose (fentanyl 0.5 mcg/kg) to reduce stress level. The outcome of this treatment protocol was recorded.</p><p><strong>Results: </strong>PDA spasm occurred in 8 (4 %) of the patients between 8 months and 7 years. Complete resolution of spasm was attained after 10-45 min of anesthesia management. All 8 ducts were successfully occluded but one of them had significant residual shunt after device deployment, so larger device was used instead. No cases were referred for surgery.</p><p><strong>Conclusions: </strong>Ductal spasm at the start of anesthesia induction can be effectively managed, allowing the procedure to be safely completed, by following a straightforward anesthetic protocol.</p>","PeriodicalId":17319,"journal":{"name":"Journal of the Saudi Heart Association","volume":"38 2","pages":"12"},"PeriodicalIF":1.4,"publicationDate":"2026-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13384515/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148604345","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"CT-derived Epicardial Adipose Tissue Density and Its Association With Systemic Inflammation and Functional Impairment in Heart Failure With Preserved Ejection Fraction: A Prospective Cross-sectional Study From Oman.","authors":"Arif Albulushi, Ahmed Tawfek, Ahmed Basuoni","doi":"10.37616/2212-5043.1501","DOIUrl":"10.37616/2212-5043.1501","url":null,"abstract":"<p><strong>Background: </strong>Heart failure with preserved ejection fraction (HFpEF) is strongly influenced by cardiometabolic comorbidity and systemic inflammation. Epicardial adipose tissue (EAT) is a biologically active visceral fat depot in direct contact with the myocardium, and CT-derived EAT density (attenuation) may reflect inflammatory adipose remodeling beyond adipose quantity alone. However, the clinical relevance of EAT density in HFpEF remains uncertain.</p><p><strong>Objectives: </strong>To evaluate the association of CT-derived EAT density with systemic inflammatory biomarkers, functional capacity, health status, and echocardiographic indices of HFpEF severity in a prospective cross-sectional cohort.</p><p><strong>Methods: </strong>In a prospective cross-sectional study conducted between January and July 2024 at a tertiary cardiac center in Oman, consecutive patients with HFpEF underwent non-contrast ECG-gated cardiac CT for EAT assessment, laboratory profiling including inflammatory biomarkers, transthoracic echocardiography, 6-min walk testing (6MWT), and Kansas City Cardiomyopathy Questionnaire (KCCQ) evaluation. EAT density was analyzed both as a continuous variable and in exploratory categorical analyses. Associations were examined using correlation analyses and multivariable linear regression with adjustment for clinically relevant covariates.</p><p><strong>Results: </strong>Among 110 participants (mean age 65 ± 10 years; 53% women), mean EAT density was -85 ± 10 HU. Higher EAT density was associated with higher hs-CRP (r = 0.50, p < 0.001), IL-6 (r = 0.48, p < 0.001), and TNF-α (r = 0.46, p < 0.001). Higher EAT density was associated with higher hs-CRP (r = 0.50, p < 0.001), IL-6 (r = 0.48, p < 0.001), and TNF-α (r = 0.46, p < 0.001). In exploratory adjusted analyses incorporating natriuretic peptide burden, renal function, and other clinically relevant covariates, these associations were attenuated but remained directionally consistent. Patients with higher EAT density showed lower 6MWT distance (320 ± 75 vs 400 ± 70 m, p < 0.001) and lower KCCQ overall score (60 ± 12 vs 75 ± 10, p < 0.001). These findings should be interpreted cautiously pending fuller adjustment for HF severity, renal function, and treatment-related covariates.</p><p><strong>Conclusions: </strong>In this HFpEF cohort, higher CT-derived EAT density was associated with greater inflammatory burden and worse functional status. These findings suggest that EAT density may serve as an imaging correlate of the cardiometabolic-inflammatory HFpEF phenotype, although further validation is required before broader clinical application.</p>","PeriodicalId":17319,"journal":{"name":"Journal of the Saudi Heart Association","volume":"38 2","pages":"16"},"PeriodicalIF":1.4,"publicationDate":"2026-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13384504/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148604387","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comments on the Rapid Access Chest Pain Assessment Clinic: An Australian Virtual Care Experience.","authors":"Marwan Shawki, Ali H Al-Fiadh","doi":"10.37616/2212-5043.1492","DOIUrl":"https://doi.org/10.37616/2212-5043.1492","url":null,"abstract":"","PeriodicalId":17319,"journal":{"name":"Journal of the Saudi Heart Association","volume":"38 2","pages":"6"},"PeriodicalIF":1.4,"publicationDate":"2026-05-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13489145/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148794649","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comments on the Letter \"Bridging the Gap: The Critical Next Steps for Implementing Genetic Risk Scores in Myocardial Infarction Prevention in Saudi Arabia\".","authors":"Abdullah Saeed","doi":"10.37616/2212-5043.1493","DOIUrl":"10.37616/2212-5043.1493","url":null,"abstract":"","PeriodicalId":17319,"journal":{"name":"Journal of the Saudi Heart Association","volume":"38 2","pages":"8"},"PeriodicalIF":1.4,"publicationDate":"2026-05-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13267968/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148265170","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Bridging the Gap: The Critical Next Steps for Implementing Genetic Risk Scores in Myocardial Infarction Prevention in Saudi Arabia.","authors":"Ahmed A Almohammadi","doi":"10.37616/2212-5043.1487","DOIUrl":"10.37616/2212-5043.1487","url":null,"abstract":"","PeriodicalId":17319,"journal":{"name":"Journal of the Saudi Heart Association","volume":"38 2","pages":"7"},"PeriodicalIF":1.4,"publicationDate":"2026-05-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13267967/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148265126","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Quantifying Patient Positioning Errors and Radiation Dose Variation in Cardiac Computed Tomography Angiography.","authors":"Yasser H Hadi, Hassan B Hawsawi, Niamh Moore, Helle Precht, Andrew England, Mark McEntee","doi":"10.37616/2212-5043.1499","DOIUrl":"10.37616/2212-5043.1499","url":null,"abstract":"<p><strong>Objectives: </strong>Accurate patient centring at the computed tomography (CT) scanner isocentre is essential for optimising radiation dose. This study aimed to quantify positioning errors, assess their relationship with radiation dose, and estimate the potential dose reduction achievable with optimal centring.</p><p><strong>Methods: </strong>This retrospective observational study included adult patients (≥18 years) who underwent electrocardiography (ECG)-gated cardiac CT angiography between January 2023 and July 2025 at a tertiary hospital. Scans were performed using Siemens SOMATOM Force dual-source CT systems. Vertical and lateral deviations from the scanner isocentre were calculated from scout images using integrated analytics within the institutional dose monitoring platform (Qaelum NV, Leuven, Belgium). Radiation dose indices, including the volume-weighted CT dose index (CTDI_vol) and dose length product (DLP), were extracted from DICOM dose reports. Statistical analyses comprised descriptive statistics, correlation analysis, multivariable regression, and simulation of potential dose reductions with ideal centring.</p><p><strong>Results: </strong>Data from 399 patients were evaluated. Significant off-centring (>10 mm) occurred in 83% of scans in the anteroposterior (AP) direction and 50% laterally. Severe AP off-centring (>30 mm) was present in 39% of cases. Off-centring showed no independent association with CTDI_vol or DLP after adjustment for body mass index (BMI), age, and sex. Male patients demonstrated significantly greater off-centring in both the AP (p = 0.048) and lateral (p = 0.037) directions, and BMI category was significantly associated with off-centring magnitude in the AP (p = 0.031) and lateral (p = 0.022) directions. Literature-based scenario modelling suggested that ideal centring could hypothetically reduce mean CTDI_vol by approximately 12%, with a similar reduction in DLP.</p><p><strong>Conclusion: </strong>Patient off-centring was highly prevalent in cardiac CT examinations. No independent association between off-centring and radiation dose was observed when adjusting for BMI, age, and sex. Literature-based scenario modelling suggests that meaningful radiation dose reductions may be achievable with optimum centring, although this requires prospective confirmation.</p>","PeriodicalId":17319,"journal":{"name":"Journal of the Saudi Heart Association","volume":"38 2","pages":"3"},"PeriodicalIF":1.4,"publicationDate":"2026-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13166806/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147930687","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Value of the Non-enhanced Cardiac Computed Tomography Scan Analysis in Determination of the Appropriate Coronary CT Angiography Scan Protocol.","authors":"Osama A Smettei, Sawsan A Sayed, Fatin M Ahmed, Tawfeeq H Alharbi, Mohammed Saied, Rami M Abazid","doi":"10.37616/2212-5043.1496","DOIUrl":"https://doi.org/10.37616/2212-5043.1496","url":null,"abstract":"<p><strong>Objective: </strong>Coronary computed tomography angiography (CCTA) is a cornerstone in the assessment of coronary artery disease. Despite technological advancements, balancing radiation does with diagnostic image quality remains a challenge. This study evaluates whether assessing preliminary non-enhanced CT scans allows for the optimization of CCTA gating protocols to enhance image quality and minimize radiation exposure.</p><p><strong>Methods: </strong>We prospectively analyzed 150 patients undergoing CCTA on a 256-slice scanner. Non-enhanced scans were used to identify motion artifacts or anatomical challenges. Based on these findings, a specific gating protocol (prospective, prospective with padding, or retrospective) was selected. This cohort was compared to a control group of 150 standard CCTAs performed without protocol pre-selection. Image quality was assessed on a four-point scale, and radiation doses were recorded.</p><p><strong>Results: </strong>The mean patient age was 49 years, with a mean heart rate (HR) of 62 ± 14 beats per minute (bpm). Subjective image quality was significantly higher in the pre-selection group, particularly for patients with HR > 65 bpm (3.5 ± 0.5 vs. 2.8 ± 0.8; p = 0.06). The mean radiation dose was significantly lower in the pre-selection group (4.9 ± 1.4 vs. 7.5 ± 1.8 mSv; p < 0.01). Furthermore, the requirement for high-radiation protocols (padding or retrospective gating) was reduced by 50% in the pre-selection group (14/150 vs. 28/150 scans).</p><p><strong>Conclusion: </strong>Utilizing non-enhanced CT scans to tailor 256-slice CCTA protocols significantly improves image quality and reduces radiation exposure. This strategy offers a more personalized approach to cardiac imaging and should be considered for routine clinical practice.</p>","PeriodicalId":17319,"journal":{"name":"Journal of the Saudi Heart Association","volume":"38 2","pages":"4"},"PeriodicalIF":1.4,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13489147/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148794830","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pediatric Cardiac Imaging With Second- and Third-generation Dual Source CT Scanners: Radiation Dose, and Diagnostic Accuracy in Comparison With Echocardiography and MRI-A Systematic Review and Meta-analysis.","authors":"Lamia G Jamjoom, Razan K Daghistani","doi":"10.37616/2212-5043.1497","DOIUrl":"10.37616/2212-5043.1497","url":null,"abstract":"<p><strong>Objectives: </strong>The purpose of this study was to evaluate the diagnostic accuracy, imaging speed, radiation dose, and clinical utility of second- and third-generation dual source computed tomography scanners, in comparison with echocardiography and magnetic resonance imaging in diagnosing congenital heart disease in paediatric patients.</p><p><strong>Material and methods: </strong>A systematic literature search was conducted in PubMed, Embase, Scopus, and the Cochrane Central Register of Controlled Trials from 1 January 2006 to 30 April 2025. Eligible studies included pediatric populations undergoing cardiac imaging with modern computed tomography scanners and compared outcomes against echocardiography or magnetic resonance imaging. Study selection followed PRISMA guidelines. Risk of bias was assessed using QUADAS-2 and ROBINS-I tools. Meta-analysis was performed for sensitivity outcomes, and pooled odds ratios were calculated using fixed-effects models.</p><p><strong>Results: </strong>Twenty-four studies met the inclusion criteria, comprising 3 prospective and 21 retrospective studies involving pediatric patients with congenital heart disease. Diagnostic accuracy of computed tomography ranged from 91% to 100%, with pooled sensitivity significantly favoring computed tomography over echocardiography (OR = 3.87; 95% CI: 2.78-5.38; P < 0.00001). Radiation doses were consistently low, ranging from 0.21 to 0.70 mSv with high-pitch and electrocardiogram-gated protocols. Several studies reported clinical impact, including changes in surgical planning and improved anatomical visualization. Risk of bias was moderate in most studies, primarily due to confounding and retrospective designs.</p><p><strong>Conclusions: </strong>Cardiac computed tomography demonstrates high diagnostic accuracy and provides detailed anatomical visualization in pediatric patients with congenital heart disease. It is particularly valuable for assessing extracardiac structures and complex vascular anatomy, where it may complement echocardiography and cardiac magnetic resonance imaging. While radiation exposure has been substantially reduced with newer-generation technologies, the interpretation of findings should consider the methodological limitations of included studies. Further prospective research is needed to strengthen the evidence base.</p><p><strong>Prospero registration: </strong>CRD420251042099.</p>","PeriodicalId":17319,"journal":{"name":"Journal of the Saudi Heart Association","volume":"38 2","pages":"2"},"PeriodicalIF":1.4,"publicationDate":"2026-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13142678/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147839602","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Advancing Lipid Management: Saudi Heart Association Position Statement on PCSK9-targeted Therapies in the Primary and Secondary Prevention of Cardiovascular Disease.","authors":"Waleed AlHabeeb, Hussein Alamri, Hussein Elbadawi, Yazed S AlRuthia, Waleed Alharbi, Owayed Alshammeri, Adel Tash, Shadi Almoziny, Naji Kholaif, Hussain Halawani, Fadia AlMahdi, Wael Yar, Khalid F Alhabib","doi":"10.37616/2212-5043.1488","DOIUrl":"10.37616/2212-5043.1488","url":null,"abstract":"<p><strong>Background: </strong>Despite robust evidence for low-density lipoprotein cholesterol (LDL-C) reduction in atherosclerotic cardiovascular disease (ASCVD) prevention, attainment of guideline-recommended targets remains suboptimal in Saudi Arabia, especially among high- and very high-risk patients. Proprotein Convertase Subtilisin/Kexin Type 9 (PCSK9)-targeted therapies, which include monoclonal antibodies (evolocumab, alirocumab) and small interfering RNA (inclisiran), offer potent LDL-C lowering that can help address this gap.</p><p><strong>Methods: </strong>The Saudi Heart Association (SHA) convened a multidisciplinary panel to review evidence from randomized controlled trials, real-world studies, and economic analyses on PCSK9-targeted therapies. Recommendations were developed through expert consensus, contextualized to the Saudi healthcare environment.</p><p><strong>Results and conclusions: </strong>PCSK9 inhibitors (evolocumab, alirocumab) lower LDL-C substantially by around 60% and reduce the risk of adverse cardiovascular outcomes when added to maximally tolerated statins. Inclisiran achieves similar LDL-C reductions with biannual dosing, potentially improving adherence, though cardiovascular outcome data are pending. Both drug classes are well tolerated across diverse patient populations, including those with high or very high-risk, familial hypercholesterolemia (FH), recent acute coronary syndrome (ACS), or statin intolerance. The SHA expert panel recommends the early integration of upfront combination treatment including PCSK9-targeted therapies for patients with high risk features unlikely to reach LDL-C goals with statins ± ezetimibe, including recent ACS, FH, established ASCVD, metabolic conditions with end-organ damage, and statin intolerance. For Saudi populations, targeted integration of these agents into combination regimens offers a significant opportunity to close LDL-C treatment gaps and reduce residual ASCVD risk.</p>","PeriodicalId":17319,"journal":{"name":"Journal of the Saudi Heart Association","volume":"38 1","pages":"16"},"PeriodicalIF":1.4,"publicationDate":"2026-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13249161/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148218300","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}